不同透析方式对终末期糖尿病肾病患者Klotho蛋白、FGF-23及颈动脉内膜中层厚度的影响  

Effects of different dialysis methods on Klotho protein,fibroblast growth factor-23 and carotid intima-media thickness in patients with end-stage diabetic kidney desease

作　　者：费丹峰 朱鸣[1] 任凌燕 丁敏[1] 陈琪[1] 薛涛[1] 施占琴[1] 王霄一[1] FEDan-feng;ZHU Ming;REN Ling-yan;DING Min;CHEN Qi;XUE Tao;SHI Zhan-qin;WANG Xiao-yi(Department of Nephrology,Huzhou First People's Hospital,Huzhou 313000,Zhejiang,China;不详)

机构地区：[1]湖州市第一人民医院肾内科,浙江湖州313000

出　　处：《广东医学》2020年第21期2192-2195,共4页Guangdong Medical Journal

基　　金：浙江省医药卫生科技计划项目(2016KYA172);浙江省科技厅项目(2017C37106);湖州市科学计划项目(2014GZ09、2016GY27)。

摘　　要：目的探讨不同透析方式对终末期糖尿病肾病(DKD)患者血清Klotho蛋白、血清成纤维细胞生长因子23(FGF-23)及颈动脉内膜中层厚度(IMT)的影响.方法选择终末期DKD患者80例,按随机数字表法分为血液透析(HD)组及腹膜透析(PD)组,每组各40例.所有患者透析后0、6、12个月均测定血清Klotho、FGF-23及颈动脉IMT水平.结果透析治疗后,血清Klotho均呈持续上升趋势,但两组同期对比差异均无统计学意义;FGF-23水平均呈持续下降趋势,但两组同期对比,治疗12个月时,PD组<HD组(P<0.05);颈动脉IMT在治疗12个月时均明显升高(P<0.05),但两组同期对比差异均无统计学意义结论HD和PD对透析12个月内颈动脉IMT的影响无明显差异。两种透析方式均能提高终末期DKD患者的血清Klotho蛋白,降低FGF-23,但PD相较于HD,在相对远期降低FGF-23方面更有优势。Objective To investigate the effects of different dialysis methods on serum Klotho protein, serum fibroblasts growth factor-23(FGF-23) and carotid intima-media thickness(IMT) in patients with end-stage diabetic kidney disease(DKD). Methods A total of 80 patients with end-stage DKD, which were hospitalized in Department of Nephrology, were randomly divided into hemodialysis(HD) group(n=40) and peritoneal dialysis(PD) group(n=40). The levels of serum Klotho protein, FGF-23 and carotid IMT were measured in all patients 0, 6 and 12 months after dialysis. Results After dialysis treatment, the serum Klotho protein showed a continuous upward trend, but there was no statistically significant difference between HD group and PD group in the same period. The FGF-23 level showed a continuous downward trend, but there was no statistically significant difference between the HD group and the PD group at 6th month, but it was significantly lower in the PD group significantly than the HD group at the 12th months(P<0.05). Carotid IMT was significantly increased at the 12th months of treatment(P<0.05), but there was no significant difference between the HD group and the PD group. Conclusion There was no significant difference between HD and PD on carotid IMT within 12 months of dialysis. HD and PD could increase serum Klotho protein and reduce FGF-23 in patients with end-stage DKD. However, compared with hemodialysis, peritoneal dialysis has more advantages in reducing FGF-23 in a relatively long-term.

关 键 词：终末期糖尿病肾病 血液透析 腹膜透析 成纤维生长因子23 KLOTHO蛋白 颈动脉内膜中层厚度 

分 类 号：R692[医药卫生—泌尿科学] R335[医药卫生—外科学]